South African researchers name AIDS as biggest killer

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South Africa’s Medical Research Council (MRC) has named AIDS as the country’s single largest killer. A report prepared by the council — but not yet publicly released — is said to conclude that AIDS caused 40 per cent of adult deaths, and 25 per cent of total deaths, in South Africa last year.

This conclusion challenges the controversial stance taken by South African president Thabo Mbeki that the disease causes only a tiny proportion of deaths. Last month, Mbeki sent a letter to health minister Manto Tshabalala-Msimang urging her to consider a cut in the AIDS budget.

To justify his request, the president referred to six-year-old statistics from the World Health Organisation (WHO) — themselves based on figures provided by the South African government — which claimed that the disease accounted for only 2.2 per cent of deaths.

But the MRC report, whose contents have been widely quoted in the national press following its circulation to members of the government, is said to predict that if no effective treatment is provided, 4 to 7 million South Africans will die from the disease by 2010. The figures are consistent with recent WHO statistics that put AIDS as the main cause of death in South Africa.

Mbeki’s letter caused outrage worldwide among AIDS activists and doctors, who argued that the number of AIDS deaths has been increasingly rapidly over the past few years.

The new MRC report backs their case. The report, written by a panel of South African researchers, states that adult AIDS-related deaths have increased from 9 per cent in 1995 to 40 per cent in 2000.

The report could be crucial in lifting the country out of its “state of denial” on HIV and AIDS, according to William Makgoba, president of the MRC. He told the South African newspaper Business Day that “this country will have to make a major commitment to policy and action”.

Despite the report’s conclusions, Mbeki has not retracted his statement. This is not the first time that the South African president has been criticised for downplaying the scale of the AIDS crisis; he has angered scientists in the past by publicly questioning the link between HIV and AIDS.

The government is currently preparing to defend its AIDS policies against legal action initiated last month by the South African Treatment Access Campaign (TAC). Tshabalala-Msimang and nine provincial health ministers have been accused of failing adequately to prevent mother-to-child transmission of HIV.

In particular, TAC is demanding that all HIV-positive pregnant women are given a course of treatment of nevirapine, a drug that reduces mother-to-child transmission. TAC, a grassroots organisation that aims to prevent new HIV infections and ensure access to affordable AIDS treatment, says that without nevirapine, almost 100,000 babies in South Africa will contract HIV unnecessarily by 2003.

Nevirapine is registered for use in South Africa and is widely prescribed by private doctors. Furthermore, the German pharmaceutical company Boehringer Ingelheim has offered to provide the drug free of charge for the next five years. In the public sector, however, the government has restricted its use to pilot sites, meaning that most HIV-positive women are denied the drug.